Provider Demographics
NPI:1154799617
Name:ATLIS ENTERPRISES LLC
Entity type:Organization
Organization Name:ATLIS ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:III
Authorized Official - Credentials:MSN, APRN, FNP-C
Authorized Official - Phone:210-827-9954
Mailing Address - Street 1:2208 RANCH ROAD 620 N APT 3103
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78734-2817
Mailing Address - Country:US
Mailing Address - Phone:210-827-9954
Mailing Address - Fax:
Practice Address - Street 1:624 ALTEA DR
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641
Practice Address - Country:US
Practice Address - Phone:210-827-9954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2023-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No251K00000XAgenciesPublic Health or Welfare
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service